Electrosurgical devices for coagulating bleeding tissue have been available for some time. Most generally, such devices include a hollow conductive tube having an insulating coating over all but a most distal tube portion, so that the distal tube portion forms a generally annular ablating electrode; a hollow insulating handle coaxially surrounding the tube; a suction source attached to a proximal portion of the tube for evacuating excess blood and smoke from the surgical site; and wire electrical connectors attached to a power source for electrically activating the electrode. Such a device is described in, for example, U.S. Pat. No. 4,932,952 (Wojciechowicz, Jr., 1990).
Hemostasis in the nose can be desirable to treat a severe nosebleed, and to close surgically created wounds in the nose. None of the electrosurgical coagulation devices known to the inventor have been engineered with the particular problems associated with nasal hemostasis. While known electrosurgical devices are used to effect nasal hemostasis, such devices have not been optimized. In particular, the electrodes do not provide for precision coagulation. The generally ring-shaped electrodes have a circular cross section and therefore do not allow for selective ablation except by repositioning the entire device--stated another way, the circular electrodes are blunt and do not provide highly selective control. While electrosurgical knives are known (see for example U.S. Pat. No. 4,960,419 (Rosenberg, 1990), attaching a separate blade to a suction tube increases the manufacturing complexity as compared to the above described method of electrically activating a conductive tube so that the tube is both an electrode and a suction element. Other shaped electrosurgical tips are disclosed in U.S. Pat. No. 5,267,994--again, such tips are physically distinct from a suction tube and are therefore more complex and may be less reliable than the simpler cylindrical device first described above. A tip having more precision than the cylindrical shape, while maintaining its essential simplicity and reliability, will provide an improved coagulation device.
Electrosurgical suction coagulators can clog with blood or tissue during operation, interrupting the hemostasis procedure and requiring additional effort by the operating physician and staff. A venting port in the handle of a device may reduce clogging, but does not prevent it. See Wojciechowicz, Jr. for a description of such ports. Ventilation ports also hinder 360 degree operation of a device, in that a physician cannot easily rotate a device while maintaining a finger over the port.
A coagulator that is more postionalble, more accessible to a tangential passage, less prone to clogging, and easier to clean if clogged than known coagulators is therefore a welcome advance in the art, particularly when such benefits are realized in a rugged, reliable, and relatively simple design.